Stable blood sugar linked to heart stent outcomes

Patients with type 2 diabetes and a coronary stent are at lower risk for heart attack and stroke if they maintain good blood sugar control, according to a recent study.

“Although intensive glucose control had no benefit on the rate of major cardiovascular events in previous studies, our data suggest that strict glucose control after PCI (heart catheterization) can improve long-term clinical outcomes in diabetic patients,” Dr. Joo-Yong Hahn from Samsung Medical Center in Seoul said in an interview with Reuters Health.

Researchers looked at 980 patients with type 2 diabetes and a stent, examining long-term blood sugar control and comparing it to the patient’s risks of death, heart attack, repeat catheterizations and stroke. The team defined good blood sugar control as an A1C score below 7.0 and poor control as anything above 7.0.

After matching patients according to risk factors, the researchers ended up with 322 pairs of patients.

The risk of all bad outcomes was 1/4 lower for patients with stable blood glucose compared to those with poor blood glucose control, according to Reuters. 

In the matched groups, about 37% of patients with poor blood sugar control had bad outcomes over the 7-year study period. In comparison, just 8% of patients with good control experienced  bad outcomes such as heart attack and stroke. Most of the outcome differences between the 2 groups were due to repeat stenting in the group with poor blood glucose control.

“PCI is not the end of treatment for coronary artery disease,” Hahn told the news outlet. “Optimal medical treatment, including glycemic control, is a cornerstone therapy after PCI.”

“The effects of glucose control in type 2 diabetes may differ according to patient characteristics, such as recent cardiovascular events, baseline glycemic control status and duration of diabetes.”

The team cautioned that more work should be done before the industry can conclude that strict blood glucose control after stenting will improve long-term clinical outcomes in diabetes patients. But Dr. Azfar Zaman from Newcastle University, who was not involved in the study, said this work supports data from previous studies.

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